Effects of diabetes, patient age, and health insurance provider on the number of drugs ordered or provided per physician visit in the USA

Purpose: The purpose of this paper is to examine the effects of diabetes, patient age, and health insurance on the number of prescription and non-prescription drugs mentioned (ordered or provided) per physician visit in the USA. Design/methodology/approach: The National Center for Health Statistics annually conducts three surveys about ambulatory care physician visits: the National Ambulatory Medical Care Survey, the National Hospital Ambulatory Medical Care Survey - outpatient departments, and the National Hospital Ambulatory Medical Care Survey - emergency departments. For this study, the data collected in 2003 and 2004 by these surveys were analyzed with the SAS procedures SURVEYMEANS and SURVEYREG, which can take into account the multistage sample design of these surveys. Findings: Regression analyses show significant effects of diabetes, patient age, and health insurance provider on the number of prescription drug mentions and non-prescription drug mentions per physician visit. Among adults greater than 18 years old, and even for visits by persons greater than 75 years old, diabetes visits relative to non-diabetes visits had significantly more prescription drug mentions per visit and significantly more non-prescription drug mentions per visit physician visits, for both general purposes and diabetes, without insurance coverage had significantly fewer prescription drug mentions per visit than the corresponding visits covered by either private health insurance, Medicare, or Medicaid. Thus, the results show that physicians use more prescription drugs and non-prescription drugs to manage diabetes visits than non-diabetes visits and prescribe fewer medications when patients have no insurance than when they have Medicare, Medicaid, or private health insurance. Originality/value: Results from a nationally representative sample of physician visits in the USA show that physicians order or provide substantially more drugs for diabetes visits. These results suggest that diabetes sharply increases drug consumption. Also, physicians are likely to prescribe more medications to patients who have health insurance relative to patients without health insurance.